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CYSTIC FIBROSIS SERVICES, LLC
DSH140093 OSF SACRED HEART MEDICAL CENTER
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Covered Entity Details
Entity Name
OSF SACRED HEART MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140093
Entity Address
812 NORTH LOGAN AVENUE
DANVILLE, IL 61832-3752
Medicare Provider Number
140093
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
CYSTIC FIBROSIS SERVICES, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16280
10530 JOHN W ELLIOTT DR STE 200
FRISCO, TX 75033
Pharmacy Comments
Contract Details
Approval Date
6/28/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/9/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Deborah Schimerowski, Regional CFO
(815) 725-7133 Ext: 7667
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/28/2017
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